Most Nocturnal Asthma Symptoms Occur Outside of Exacerbations and Associate with Morbidity

Horner, Caroline C.; Mauger, Dave; Strunk, Robert C.; Graber, Nora; Lemanske, R.F.; Sorkness, C.A.; Szefler, S.J.; Zeiger, R.S.; Taussig, Lynn M.; Bacharier, Leonard B.

doi:10.1016/j.jaci.2010.12.532

Cited by 5 publications

(6 citation statements)

References 13 publications

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“…Together these findings highlight sleep disruptions in young children with asthma, most notable in children with poorly controlled asthma, but also when asthma is well-controlled, similar to previous findings in older children and adolescents (e.g. Daniel et al, 2012; Horner et al, 2011; Meltzer et al, 2014).…”

Section: Discussionsupporting

confidence: 85%

“…Sleep problems are common in youth with asthma (Daniel et al, 2012; Meltzer et al, 2014), including prolonged sleep onset latency, frequent night wakings, and daytime sleepiness, even when asthma symptoms are well controlled (Chugh et al, 2006; Horner et al 2011; Sadeh et al, 1998; Stores et al, 1998; Yuksel et al, 2007). Yet only one study has examined sleep patterns in young children, with no significant differences found between young children with and without asthma (Tirosh et al, 1993).…”

Section: Introductionmentioning

confidence: 99%

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Sleep in young children with asthma and their parents

Meltzer

Pugliese

2017

J Child Health Care

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Sleep problems are common in healthy young children, as well as in older children and adolescents with asthma; yet little is known about the sleep patterns and sleep issues of young children with asthma. Further, when young children have sleep disruptions, parental sleep is also typically disrupted. The purpose of this study was to characterize sleep in young children (one to four years) with and without asthma and their parents. Parents of young children ( n = 364) from the general community completed measures of sleep patterns and sleep issues in their children and in themselves. Compared to children with well-controlled asthma or no asthma, children with poorly controlled asthma had poorer sleep patterns, more difficulty falling asleep, and more sleep disruptions (i.e. restless sleep, frequent apneas and gasping during sleep, and frequent sleep terrors). Parents of children with poorly controlled asthma indicated their own sleep was regularly disrupted, and they had frequent night awakenings due to attending to, and stress caused by, their child's health needs. Children with poorly controlled asthma and their parents demonstrated significant sleep issues. Clinical implications for working with young children with asthma and their parents are discussed.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Sleep in young children with asthma and their parents

Meltzer

Pugliese

2017

J Child Health Care

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“…It might be argued that criteria for well‐controlled asthma in children may differ from those in adults. In children, in particular limitation of activities and nocturnal symptoms may impact the quality of life of the children and their caregivers . Based on GINA criteria, the diagnostic performances of the ACT or ACQ in assessing levels of asthma control have been evaluated in several studies.…”

Section: Gold Standard Of Asthma Controlmentioning

confidence: 99%

Asthma control questionnaires in the management of asthma in children: A review

et al. 2014

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Several self-administered questionnaires have been developed to assess childhood asthma control in a simple and standardized way. This review discusses the most commonly used questionnaires and explores their usefulness in asthma management in children. We conclude that the use of asthma control questionnaires in daily practice and in research contributes to the standardized evaluation of children with asthma and helps to track asthma symptoms, but validation studies in a wider range of settings are needed.

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“…Specifically, night awaking due to asthma‐like symptoms was predictive of this outcome. Previous studies have found increased incidence of sleep difficulties in preschoolers with wheezing, particularly those with uncontrolled disease, suggesting that this characteristic is a marker of a more severe phenotype . Additionally, sleep deprivation may lead to an increase of proinflammatory cytokines, which could exacerbate inflammatory conditions such as asthma .…”

Section: Discussionmentioning

confidence: 99%

Test for respiratory and asthma control in preschool kids in the emergency department as a predictor of wheezing exacerbations

Harel‐Sterling

Dai

Moraes

et al. 2020

Pediatric Pulmonology

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Objective The test for respiratory and asthma control in kids (TRACK score) is a standardized questionnaire tool validated to identify poor symptom control in children with stable preschool wheeze. This study determined if TRACK score measured within 5 days of an Emergency Department (ED) visit for acute wheezing predicts a subsequent wheezing exacerbation requiring an ED visit and/or treatment with systemic corticosteroids within 3 months. Methods This was a single‐center prospective cohort study of children aged 36 to 71 months who presented to the ED with an acute episode of wheezing and had TRACK score measured at a clinic visit within 5 days of the index ED encounter, focused on information about symptoms occurring before the onset of the current acute episode. The outcomes were the independent association of a repeat wheezing exacerbation with the overall TRACK score (primary) and with mutually uncorrelated TRACK items (secondary), adjusted for sex and atopy. Results We enrolled 102 children; median age 52.3 (44.1, 59.9) months, 59% males. Of these, 33 (32.4%) had further wheezing exacerbations. For each 10 unit decrease in TRACK, the odds of a future exacerbation was 1.38 (95% CI, 1.10‐1.75); male sex demonstrated OR, 5.13 (1.84‐14.33). A model that included TRACK items reflecting more than equal to 1 awakenings for wheezing in the past 4 weeks, receipt of more than equal to 2 courses of corticosteroids in the last year and male sex was predictive of wheezing exacerbations: OR, 6.43 (2.18‐19.00). Conclusion In preschoolers with acute wheezing episodes in the ED, we have identified the TRACK score components which, together with male sex, can be used to identify children at risk of future exacerbations requiring referral for specialized care. These results need to be confirmed and validated in other populations enrolled at multiple sites before they can be implemented in practice.

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Most Nocturnal Asthma Symptoms Occur Outside of Exacerbations and Associate with Morbidity

Abstract: Background-Although nocturnal awakenings help categorize asthma severity and control, their clinical significance has not been thoroughly studied.

Cited by 5 publications

References 13 publications

Sleep in young children with asthma and their parents

Sleep in young children with asthma and their parents

Asthma control questionnaires in the management of asthma in children: A review

Test for respiratory and asthma control in preschool kids in the emergency department as a predictor of wheezing exacerbations

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